Why do patients with multiple sclerosis develop progressive disability

In a study published in the journal Neurology, researchers and colleagues at the Mayo Clinic assessed whether inflammation can cause permanent scars in the following three diseases:

• Primary sclerosis (MS)

• Neuromyelitis optica spectrum disorder with positive aquaporin 4 antibody (AQP4-NMOSD)

• Myelin oligodendrocyte glycoprotein antibody-related disease (MOGAD)

They also investigated whether scars may be the reason why patients with AQP4-NMOSD and MOGAD do not have slow progressive disability compared with multiple sclerosis

"The differences in scars we found will help doctors more easily distinguish between these three diseases, thereby helping to diagnose

In all three diseases, the body’s immune system targets myelin, which is an insulator around nerves.

The study included 156 patients, including 67 MS patients; 51 AQP4-NMOSD patients; and 38 MOGAD patients

For multiple sclerosis, the researchers found that the area of ​​inflammation was only moderately reduced, and a medium-sized scar was formed

"Our research emphasizes the importance of the currently available multiple sclerosis drugs, which can be very effective in preventing the onset of multiple sclerosis, new lesions and subsequent scar formation," said Elia Sechi, MD, who was previously A researcher at the Mayo Clinic and the first author of this study

However, AQP4-NMOSD and MOGAD are different from MS because they do not have the slow disability deterioration typical of MS progression

AQP4-NMOSD, during the attack, there will be a large area of ​​inflammation, which usually leads to severe symptoms

For MOGAD, despite the extensive inflammation during the attack, the researchers found that over time, the lesions tend to disappear completely without leaving any scars

The researchers pointed out that the reasons behind this recovery are unclear

Dr.